According to a 2013 report from the Centers for Disease Control and Prevention (CDC), genital herpes is the second most common sexually transmitted disease in the United States. Herpes simplex virus type 1 or type 2 can cause genital herpes. Herpes simplex type 2 causes most cases of genital herpes infection and is more common in women than men. CDC notes that 45 percent of all newly diagnosed herpes infections occur in people aged 15 and 24. It's important for women to recognize the early vaginal signs and symptoms of herpes so appropriate testing and treatment can begin.
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Early Vaginal Symptoms
The first vaginal symptoms from genital herpes typically develop 2 to 12 days after infection with the virus, which can occur with sexual contact that does not necessarily include intercourse. Women may experience so-called prodromal symptoms before the development of sores, which can include itching, tingling, burning or pain in the genital area. These symptoms can occur a few hours to a day before the skin sores caused by herpes appear.
When a genital herpes outbreak occurs, one or more blister-like, fluid-filled sores develop. They may occur anywhere on a woman's external genitals, buttocks or the upper aspect of inner thighs, or at the vaginal opening or inside the vagina. These lesions are called vesicles, and they commonly occur in small clusters. There can be just a few sores or many of them. The vesicles usually break open in a day or two, leaving painful open sores. With time, the sores crust over and eventually heal. Women experiencing a herpes outbreak may also have vaginal discharge, burning with urination and swollen lymph nodes in the groin area. An initial herpes outbreak typically lasts 2 to 4 weeks. During this time, the herpes virus is easily spread to others.
General Body Symptoms
With a first outbreak of genital herpes, it is relatively common for women to experience other symptoms in addition to vaginal discomfort. These generalized or systemic symptoms are similar to those of other viral infections and can include fever, headache and body aches. These symptoms are usually most severe in the first few days of the infection and can last for up to 2 weeks.
Herpes Without Symptoms
Most people who have genital herpes are not aware that they've been infected. CDC reports that about 81 percent of people between 14 and 49 with genital herpes have not been diagnosed with the condition. This is because most infections cause either no symptoms or mild symptoms that can easily be attributed to something else. For example, the urinary symptoms that can accompany a herpes outbreak may be attributed to a yeast or urinary tract infection. Importantly, however, herpes can still be spread to others even in the absence of symptoms.
See Your Doctor
Any woman who experiences vaginal burning or tingling, or vaginal sores should see her doctor for medical evaluation. Testing can be done to determine the cause and proper treatment, and counseling can help manage the spread of genital herpes if this common infection is diagnosed. For an initial outbreak of genital herpes, CDC recommends 7 to 10 days of antiviral medication, such as acyclovir (Zovirax), valacyclovir (Valtrex) or famciclovir (Famvir).
Reviewed and revised by: Tina M. St. John, M.D.